The Cincinnati Children's Hospital Medical Center study may help prevent necrotizing enterocolitis (NEC), a condition primarily seen in preemies in which bowel tissue dies. The death rate approaches 30 percent. Survivors are at risk for short-bowel syndrome (caused by surgical removal of the small intestine) and neurodevelopmental disability.
The study is published in the journal Microbiome
The research, led by Ardythe Morrow, PhD, shows that NEC is preceded by two distinct microbial imbalances in the digestive tract, suggesting that these imbalances "may provide highly predictive biomarkers of NEC," she says.
"Using a combination of early microbial factors, we obtained a predictive value for NEC exceeding 80 percent," says Dr. Morrow. "This requires validation in larger studies, but the findings are striking."
Dr. Morrow's main analysis looked at stool and urine samples collected from 32 infants prior to the onset of disease. The infants were born at less than 29 weeks gestational age.
Eleven of the 32 went on to develop NEC. In all of these cases, NEC was preceded by a dominance of certain types of bacteria in the intestinal tract - either firmicutes in the first week of life or proteobacteria in the second week. Dominance of proteobacteria also occurred in half of those who did not develop NEC.
The team of investigators led by Dr. Morrow also identified a potential simple urine analysis that could help detect the bacterial dominance that occurs in advance of NEC. The research team will attempt to validate its findings in a national study and is studying approaches to prevent the occurrence of NEC in preterm infants.